Purpose To describe our experience concerning lung ultrasound (LUS) in the pediatric emergency clinic, and to investigate the diagnostic value of LUS in coronavirus disease‐2019 (COVID‐19). Methods Patients aged under 18 admitted to the pediatric emergency clinic with suspicion of COVID‐19, who underwent point‐of‐care LUS and from whom COVID‐19 reverse transcription polymerase chain reaction (RT‐PCR) samples were collected, were included in the study. Results Point‐of‐care LUS was performed on 74 patients in the emergency room. LUS findings were more sensitive than chest X‐ray in the early stages of the disease and in mild cases. Involvement was observed at LUS despite RT‐PCR being negative in some symptomatic patients with a COVID‐19 contact history. Conclusions We think that LUS can be beneficial in terms of identifying patients with lung involvement and staging their severity in this new disease in pediatric emergency clinics. The procedure is noninvasive, rapid, reproducible, and low cost, involving simple sterilization. Based on the current literature and our own practical experience, we think that increased use of point‐of‐care LUS can protect patients from unnecessary radiation and treatment delays during the COVID‐19 pandemic.
Giriş ve Amaç: Astım çocukluk çağında en sık görülen kronik hastalıktır. Mevsimsel değişikliklerin, astım atak sayıları ve hastalığın kontrol altında olma durumunu etkilediği bilinmektedir. BU çalışmada astım tanılı 6-11 yaş arasındaki olguların çocukluk çağı astım kontrol testi (Ç-AKT) ile değerlendirilmesi ve astım kontrolünü etkileyen faktörlerin belirlenmesi amaçlanmıştır.Yöntem ve Gereçler: Çalışmaya astım tanısıyla takipli 6-11 yaş arası 103 olgu alındı. Olgulardan Çocukluk Çağı Astım Kontrol Testi (Ç-AKT) ve tarafımızca hastaların değerlendirilmesi için düzenlenen astımlı anketini doldurmaları istendi.Bulgular: Çocukluk çağı astım kontrol testi (Ç-AKT) sonucuna göre olguların %47,5'inin (n=49) kontrol altında olduğu saptandı. Kontrol altında olan grupta yıllık atak sayısı (medyan=2/yıl, minimum=0/yıl, maksimum=10/yıl) kontrol altında olmayan gruba göre ( medyan=3,5/yıl, minimum=0/yıl, maksimum=10/yıl) anlamlı olarak azdı (p=0,005). Kontrol altında olan olguların %14,3'ünün (n=7), kontrol altında olmayan olguların %38,9'unun (n=21) ailesinde egzama öyküsü olduğu tespit edildi (p=0,005). Hastaneye başvuru oranları kontrol altında olan olgularda: Eylül ayında %30,6 (n=15), Ekim ayında %32,7 (n=16), Kasım ayında %30,6 (n=15) ve Aralık ayında %6,10 (n=3); kontrol altında olmayan olgularda Eylül ayında %5,6 (n=3), Ekim ayında %25,9 (n=14), Kasım ayında %33,3 (n=18) ve Aralık ayında %35,2 (n=19) olarak saptandı. Aralık ayında kontrol altında olmayan olguların, kontrol altında olan olgulara göre daha sık başvurduğu tespit edildi (p=0,001).Tartışma ve Sonuç: Astım kontrol testleri hastaların takiplerinde hekimlere yardımcı olan pratik bir uygulamadır. Çalışma sonucunda astımlı hastaların önemli bir kısmının kontrol altında olmadığı görüldü. Astımlı olgularda Aralık ayında yakınmalarda görülen artışın bölgesel iklim değişiklikleri ve çevresel faktörlere bağlı olabileceği düşünüldü.
Objective The havoc caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic could not have been predicted, with children being affected worldwide. Testing for SARS-CoV-2 infection helped to define the interventions against the spread of the disease. A polymerase chain reaction (PCR) test has been the mainstay of diagnostic testing. Cycle threshold (Ct) is a semiquantitative value that indicates approximately how much viral genetic material was in the sample. The aim of this study was to evaluate the impact of Ct values among children with SARS-CoV-2 infection. Methods Between May 3, 2020 and August 3, 2020, clinical laboratory input and the data of patients with positive SARS-CoV-2 PCR tests were retrospectively studied. Results There was no statistical significance between Ct values and the patient's status, symptoms other than fever, or other laboratory findings. However, the Ct value of patients who had symptoms at the time of admission to the hospital was significantly lower. Conclusion In this study, symptomatic patients had lower Ct than asymptomatic patients that reflected higher viral loads. In evidence-based medicine applications, it might be useful to correlate the clinical history with laboratory test results. Even symptomatic patients with high Ct value coinfections, or an alternative acute infection, should be considered.
BACKGROUND: The havoc of this SARS-CoV-2 pandemic was being distributed unequally. Children, of all ages, and in all countries, are being affected. Testing for infection with SARS-CoV-2, helps to determine what interventions may need to be put in place to control the spread of disease within a community. A PCR test for COVID-19 is a test used to diagnose children infected with SARS-CoV-2, the virus that causes COVID-19. Cycle threshold (Ct) is a semi-quantitative value that tells us approximately how much viral genetic material is in the sample following testing by RT-PCR. Our aim was to evaluate how RT-PCR Ct values among children with confirmed SARS-CoV-2 compared with clinical, laboratory and demographic data. MATERIALS AND METHODS: In the study, demographic, laboratory, radiological and clinical characteristics and the effect of Ct value of patients with positive Covid-19 PCR test who applied to the Emergency Pediatric Service with the suspicion of infectious disease between May 3,2020 and August 3, 2020 were retrospectively examined. RESULTS: There was no statistical significance between the patient's hospitalization status, admission symptoms other than fever, and laboratory parameters and the mean Ct value. It was determined that the mean Ct value of the patients who had symptoms at the time of admission to the hospital was statistically significantly lower. CONCLUSION: In this study, symptomatic patients had lower Ct than asymptomatic patients; this reflects the clinical impact of increased viral load. In our study, the low Ct values in symptomatic patients and higher values in asymptomatic patients; reflects the importance of the effect on the clinic with the increase of viral load. In evidence-based medicine practices, it will be useful to check the compatibility of complaints and findings with laboratory data while evaluating patients. In addition, if the patient is symptomatic and has a high ct value, co-infections should be considered. Keywords: Children, COVID-19, Cycle Threshold, RT-PCR, pandemic
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